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Inside Dental Technology
February 2019
Volume 10, Issue 2

The Power of Connection

Using emotional intelligence to ensure optimal outcomes

Hannah Feldman

The success of the dental laboratory is dependent upon a complex ecosystem of interpersonal cooperation among dental technician, dentist, and patient. When all three can effectively communicate, the ideal outcome of a case is more likely to be achieved. The skilled navigation of these interactions is based upon a trait known as emotional intelligence, which refers to the identification and management of emotions—both one's own and those of others. This is the ability that allows us to know what we are feeling and how to regulate those emotions, which is a crucial skill in the workplace.

"Emotional intelligence is something that's totally underestimated as an essential," says Allen Tappe, founder and owner of the Tappe Group, a coaching organization that has worked with dental professionals for over 20 years. "I don't think there's a choice about engaging in an emotional relationship when you're trying to bring value to a marketplace. In a business, you're going to be engaging people, whether as customers, patients, or teammates." The concept of emotional intelligence burst into the general consciousness in 1995 when Daniel Goleman published a book on the subject. It presented findings drawn from the fields of psychology and affective neuroscience. Since then, it has been integrated into education, scholarship, research, and business, fueling a focus on company culture and employee development, as well as providing new methodologies for hiring and promoting. However, this isn't necessarily a new concept for the world of dentistry—just the latest evolution of the approach.

"I grew up with a concept called relationship-based dentistry," says Victor Avis, DDS. "When you have a relationship with the patients that is based on trust and a genuine rapport, you are better able to care for them. And not only does it better serve the patients, but my staff and I enjoy our work more because we're treating people who have become friends."

Meeting the Patient

Emotional intelligence is a vital skill to develop when the goal is the greatest possible patient satisfaction and acceptance rate. Not every laboratory technician will have the chance to meet each patient in person, but that is an effective way to establish an emotional connection. Whenever the chance for an in-person meeting presents itself, it should be seen as an opportunity to bring that case to the next level.

"I think it's imperative," says Eric Kukucka, DD, President of the Denture Center in Ontario, Canada. "If a dental technician does get the opportunity, they should go chairside and just see the patient, see their facial features and architecture, and ask them to describe what they're looking for in their own words."

This in-person contact gives the technician a better idea of what the patient is truly looking to achieve. Having the correct function is essential, but the personal impact of a smile upon psychological well-being can't be overstated.

"In cosmetic or high-end restorative dentistry, at least 50% of the case is emotional," says John Heimke, DMD, MPH, FAGD. "We use our teeth to consume food, but we also use our mouths to relate to others, and there's a tremendously emotional aspect to it. Many people feel like their interactions are negatively impacted and they cannot function properly when they lack the confidence to smile."

And giving that patient the confidence they need may not be as simple as just creating a technically superior restoration. Patients may have very specific wants or needs—or may have no idea what they want. Either situation requires careful questioning and consideration, and every patient's wants and needs will be as unique as they are.

"Everyone has different opinions about what is beautiful or esthetic or natural," says Pinhas Adar, MDT, CDT. "It's not our job to judge anybody. It's our job to show what's possible."

Not everyone wants a natural restoration, Adar explains. Some patients are looking for white, flashy teeth and will be disappointed with something that, to a technician's eyes, is a wonderfully crafted, esthetic, natural restoration. It's important to keep in mind that technicians and consumers will have different standards, and at the end of the day, it is the patient's happiness that is most important.

However, some patients may have desires that simply cannot be met. In that case, the technician must be prepared to gently lead them toward a more feasible solution or, if the patient refuses to be swayed, to turn down the case entirely.

"A few patients have come to us and asked us to make their teeth look like a certain celebrity or someone with a different facial structure," says Dene LeBeau, owner of LeBeau Dental Laboratory in Renton, Washington. "If that happens, the best way to avoid problems is to begin the case with a digital mock-up. Then you can use that as a tool to explain why you can or cannot meet their expectations. A digital representation can prove that a celebrity's teeth will not look good in a patient's mouth. Honest dialogue is essential."

This is a situation where emotional intelligence is vital, and could mean the difference between patient acceptance of a realistic solution and rejection of the case. A conversation with the technician can be the tipping point into case acceptance, especially when the technician takes the time to explain what they are doing and why.

"If you talk to someone about what they want and discuss the possible shortcomings with them beforehand, they're much more accepting," says David Black, DDS. "When you have built a trusting relationship with the patient and you have discussed possible compromises, they become willing to accept something that is short of perfect because they understand the challenges involved."

Gaining that mutual understanding is at the heart of emotional intelligence. As much as the technician needs to know what the patient wants, the patient also needs to know what to expect from the laboratory.

"If the patient doesn't visit the laboratory, it becomes a black box process for them," says Avis. "I take an impression, they come back in, and we put in the restoration, but they have no real understanding or respect for what goes into creating that prosthesis. When they go to the laboratory, they begin to understand all the effort that goes into fabricating a restoration that will function well but is also esthetic and mimics nature. It creates great value for both the dentist and the laboratory."

Long-Distance Patient Relationships

Meeting the patient face-to-face can be a benefit to both parties, but often it's simply not practical. When laboratories work with people all over the country, in-person consultations become unrealistic. Nonetheless, building a personal connection with the patient isn't out of reach.

"It's possible to connect with a patient using video conferencing," Adar points out. "I don't have to meet with a patient personally in order to discuss their motivations and needs. It's easy and inexpensive, and you can have a visual connection, no matter the patient's location."

Video conferencing is just one solution, and while it takes less time than actually meeting with a patient, there still is not enough time in the day to meet with every patient who will be receiving a prosthetic rehabilitation. This is where the benefits of a strong collaboration with the dentist begin to appear.

"Even if the technician can't be there, the dentist can discuss the important role a technician plays with the patient," Kukucka suggests. "They can take photographs and let the patient know that those images will be sent to the laboratory so that the technician can see the initial situation and correlate it with the specific wants and needs of the patient. The dentist can instill in the patient that it is a collaboration, and that everybody involved wants the best outcome and the best results."

Talking Techniques

Good communication is key to insuring patient satisfaction, and the dual components of that are, of course, listening closely and knowing what to say. Emotional intelligence is a vital factor in learning how to do both well.

"Building a rapport with the patient depends upon active listening," says Black. "You can position your body so that you're on the same level as the patient, look them in the eye, and actually take the time to ask questions and discover what they want. I think taking the time to get to know someone is the best technique you can use."

Another factor to consider is that patients will often be nervous about the procedure that is being planned.

"Everybody, deep down, is a little bit dental-phobic," says Richard Sousa, DDS. "So I always assume that people are apprehensive and that they will need some hand-holding and confidence-building before we begin."

Sousa also recommends starting the consultation off with a casual chat to put the patient at ease, and asking permission before taking a look at their teeth or suggesting photographs. This keeps the patient from becoming defensive and helps them feel calm and in control.

Photographs and illustrations can also be helpful visual aids for the technician when they are explaining the possibilities.

"We have a collection of pictures from past cases that we can bring out when a patient requests something similar to our previous work," says LeBeau. "I always bring in one of my ceramists to add value and provide their experience from comparable cases. Combining our knowledge greatly benefits the final outcome, and the patient appreciates the extra effort."

Leadership in the Laboratory

Emotional intelligence is just as essential within the laboratory team as it is when addressing the patient. It's a basic component of the leadership skills that are essential to growing any business.

"To keep your team engaged and inspired, you need a leader who makes people want to follow, rather than one who stands behind the team and pushes," says Black. "The basis for that is trust, and you earn trust when your team knows that their jobs are secure, that they are liked, and that they are trusted in turn."

Of course, even the best team will occasionally have internal struggles. When the laboratory turns argumentative or tense, emotional intelligence is the best tool to defuse the situation. This is when the leader must keep a rein on their own emotions, remain calm, and help the rest of the team find a resolution.

"When mutual trust exists between the team and their leader, it becomes possible to actually talk about problems constructively, rather than yell," says Black.

Sometimes, the best way to resolve issues is simply to take a step back and talk about it later, suggests LeBeau.

"Employees are human beings, and if we overreact to what they say, we're not displaying emotional intelligence at all," says LeBeau. "Continue the discussion in a day or two, and everyone will be better served."

When the team's leader is able to stay calm in the face of a difficult or stressful situation, that emotional control keeps the rest of the team from becoming more agitated. Keeping negative emotions out of the workplace helps to strengthen the business as a whole. Likewise, a leader expressing positive emotions can help keep the team's morale strong.

"If I'm happy, positive, and energetic, my staff is going to feel that way too. I'm an emotionally contagious person, and I try to instill my enthusiasm in my team, day in and day out. I discuss the particulars of each individual case and each patient's story to get everyone involved and excited," says Kukucka.

This emotional contagiousness may start at the top, but it also applies to every member of the staff. Each employee should know that they are an important and valued member of the team, and this positive environment will translate into better results for the laboratory's business.

"The truth is that every human being is a leader. They have an impact on the lives of those around them, and they influence the experience of the patient and everybody else on the staff," says Tappe. "Every one of the roles within the business is as important as the next."

While all team members are equally important, they are also all unique, and good leadership requires specific knowledge of each person in order to make sure that they are getting the encouragement they need.

"Everybody finds inspiration differently," says Adar. "Some people are motivated by knowledge and curiosity, while others find satisfaction in monetary bonuses. Others just like recognition and appreciation, and I find that to be the most powerful inspiration. People are energized when they are involved in the process and get to see the results, the impact we create on people's lives. To me, that's more powerful than money."

One way to foster engagement is to make sure that team members are involved in the case from the very beginning.

"I think it's huge to have team members sit in on the initial consultation so that they can hear the emotional and psychological aspects directly from the patient. For a lot of cases, we will also gather the whole team together to discuss the patient, their history, what we need to accomplish, and how we're going to do it," says Kukucka.

Involving the whole team from the start helps build a supportive culture that will benefit the business in the long run.

"Emotional intelligence helps you recognize that you depend upon your staff for success," says Tappe. "When I talk with someone who is frustrated by their employees, I tell them that there's a simple answer: You can get rid of them all. They pause for a moment, and then realize that it's not possible. These are people you depend upon for your success, and in turn you need to make sure they understand that what they do makes a difference and they have your respect. They spend a large portion of their lives at work, and the workplace culture is going to directly impact their state of mind when they go home. If you can make the laboratory into a place that also helps them live better outside of work, then you'll have no trouble retaining or hiring people—which, by the way, is one of the biggest challenges in the marketplace today."

The Art of Collaboration

The last element that is crucial for laboratory success is, of course, the dentists. As both clients and partners, it's vital that the laboratory and the dentist form a working relationship that goes beyond the standard customer exchange.

"They must begin by understanding that they need each other," says Tappe. "The laboratory is vital to what the dentist is trying to do, and the dentist represents significant value to that laboratory, both as a customer and a source of referrals to other dentists. Integrity in the relationship is really important. If the dentist promises information by a certain time, they need to deliver, and if the laboratory commits to a due date, then they need to meet it."

In order to develop that level of trust, it's necessary for the dentist and the laboratory to subscribe to similar philosophies and ensure that they are on the same page.

"When a new dentist approaches us, I offer to work with them to find out if the relationship is the right fit," says Adar. "Sometimes it's not a good fit, not because of the quality or execution of our work, but because of differing mindsets."

When pursuing a new professional collaboration, the laboratory shouldn't be afraid to ask questions to ascertain whether it will be a good fit.

"You have to be on the same wavelength," says Heimke. "A practitioner should interview the laboratories they want to work with, but they also shouldn't be surprised if the laboratories interview them back."

This exchange will let both parties know whether they are in the right place from the start, and the relationship will be able to grow from a solid base.

"I let the dentist know at the beginning that when we work together, they are the boss and the patients are in their care. However, we need to be partners in quality," says LeBeau. "The dentist's active involvement is necessary in order for the laboratory to achieve the best possible outcome. When the dentist and the laboratory have a strong partnership, the final results are better, and it's a lot more fun."

One of the most important factors in building a solid, working relationship is communication. Having worked in a laboratory for years before entering dental school, Sousa understands both sides of the equation.

"The most important thing for me is a laboratory that is not afraid to pick up the phone and talk to me, ask questions, or suggest something. Way too often, when a case is sent to the laboratory, the technician is unsatisfied with the information or finds it unclear," says Sousa. "In my experience, the single biggest mistake technicians make is trying to guess based on what they've been given. There's nothing more frustrating for a dentist than to get back something that just isn't what they had in mind. As a dentist, I would rather have them send the model back to me to trim the margin or, if necessary, take another impression."

Once trust has been built and open lines of communication have been established, this relationship needs to be maintained. A strong rapport helps productivity, according to Black, and it also leads to more repeat business. One way to cultivate the relationship is to regularly visit your dentist customers at their practices, as well as welcoming them into the laboratory.

"The technician who works on most of my cases comes to my office a lot," says Sousa, "and if I have a case that I'm working on, I'll visit the laboratory. We'll discuss the case, look over the photographs, and confer about the patient's needs. From time to time, he'll come over and actually work chairside with me in order to get the final result that we want."

Respect is also central to the relationship between dentist and technician. The work done in both the laboratory and the dental practice is challenging, and when both sides are aware of the other's hardships, it builds mutual appreciation.

"It's a hard thing being a laboratory technician," says Sousa. "I've been there. And I want the technicians to understand what I go through, as well. Dentistry can be a pretty tough job. I find that once the technicians understand what I have to deal with, the relationships get much stronger."

Developing the communication skills associated with emotional intelligence breeds empathy. When both sides understand each other, there will be less frustration and fewer misunderstandings.

"I think it's really healthy for technicians to get reminders of what dentists go through with patients," says LeBeau. "In my laboratory, I think it helps my team to be less judgmental. Patients bring a lot of expectations to dentists that are impossible to meet, and we must work through each case together."

In the end, the dental laboratory and dentist are partners in achieving a successful case and a satisfied patient. The products of emotional intelligence—understanding, communication, trust, and respect—pave the way to success for both parties.

"I need my laboratory to be successful, and even though they're not physically in my practice, they're a part of it every day," says Avis. "It's vital to have a very strong, respectful relationship. They respect my work and aren't dismissive of the time and effort it takes to, say, go back and take a second or third impression, if necessary. And I respect the care, skill, judgment, time, and education it takes to do their work well. That is what really makes up the foundation of the relationship. My relationship with my laboratory is like a marriage. There are times when not everything is right, but there's a level of love and communication there that allows us to work through it. I really encourage laboratories and dentists to invest the time to form these partnerships."

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